| NPI | 1710328307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 71457) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 7066) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2025-07-28 |