| NPI | 1831578459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D87797) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT208105) |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2020-07-07 |