| NPI | 1831835453 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: AZ R79514) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R79514) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2023-06-13 |