| NPI | 1720399512 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 57254) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.058748) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2014-07-03 |