| NPI | 1750761540 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MO 2015016609) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2015016609) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2020-03-11 |