| NPI | 1912430349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MT 98496) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID MRM-1643) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2022-06-21 |