| NPI | 1881959393 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA 126385) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125061561) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2021-12-02 |