| NPI | 1730748989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2023012202) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT218212) |
| 207R00000X Internal Medicine (Licence: PA MT218212) | |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2023-06-26 |