| NPI | 1003894916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 45667) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD059648L) |
| Enumeration Date | 2006-01-03 |
| Last Update Date | 2016-02-10 |