| NPI | 1023304185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD454523) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT199752) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2015-11-03 |