| NPI | 1861581001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL LL784) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL LL784) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2016-05-31 |