| NPI | 1902036882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 16141) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 266387-1) |
| 207R00000X Internal Medicine (Licence: MI 4301094810) | |
| Enumeration Date | 2009-07-25 |
| Last Update Date | 2019-08-26 |