| NPI | 1891136487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 006956) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ R2279) |
| Enumeration Date | 2013-07-11 |
| Last Update Date | 2022-01-18 |