| NPI | 1770591596 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM MD-2011-0547) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM MD-2011-0547) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2024-02-27 |