| NPI | 1790948545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: AL 37300) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL 37300) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: WA MD60279160) | |
| 207R00000X Internal Medicine (Licence: PA MT193301) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2018-08-15 |