| NPI | 1790737799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301066286) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301066286) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2026-02-25 |