| NPI | 1831505742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AR E-14622) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS T2826) |
| Enumeration Date | 2014-07-11 |
| Last Update Date | 2021-09-30 |