| NPI | 1659390805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 51253) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 051253) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2023-07-12 |