| NPI | 1700099223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MT 114987) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A94888) |
| 207L00000X Anesthesiology (Licence: OR MD160405) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: CA A94888) | |
| 207Q00000X Family Medicine (Licence: CA A94888) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2023-04-11 |