| NPI | 1679748669 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD442529) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 229530) | 
| Enumeration Date | 2008-04-29 | 
| Last Update Date | 2024-12-17 |