| NPI | 1912380320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME DO2916) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 264684) |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2019-06-04 |