| NPI | 1821400102 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-46309) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 94-08349) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2019-06-28 |