| NPI | 1740800887 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ R77905) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R77905) |
| Enumeration Date | 2020-04-18 |
| Last Update Date | 2021-05-05 |