| 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 | 2023-05-03 |