| NPI | 1982876579 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 034119) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 034119) |
| Enumeration Date | 2008-03-24 |
| Last Update Date | 2022-02-24 |