| NPI | 1659061018 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ R80306) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R80306) |
| Enumeration Date | 2023-05-09 |
| Last Update Date | 2024-05-28 |