| NPI | 1952894149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 290775) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072485) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2022-03-07 |