| NPI | 1801182829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 73772) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 32150) |
| 207R00000X Internal Medicine (Licence: GA 4750) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-06-14 |