| NPI | 1780976985 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 49071) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R72622) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2020-09-08 |