| NPI | 1912498478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-49508) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 66035) |
| 207R00000X Internal Medicine (Licence: NE 8201) | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2023-06-06 |