| NPI | 1871973172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 282415) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT208661) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2021-04-17 |