| NPI | 1972178465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0103439) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT223274) |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2025-04-22 |