| NPI | 1780929745 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL UO 3333) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: FL UO 3333) |
| Enumeration Date | 2012-12-03 |
| Last Update Date | 2021-03-31 |