| NPI | 1659634707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD183223) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: OR MD183223) |
| 207R00000X Internal Medicine (Licence: PA MT201096) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2021-03-03 |