| NPI | 1659696946 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q8113) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 51163) |
| 207R00000X Internal Medicine (Licence: CT 207r00000x) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2019-03-07 |