| NPI | 1053791251 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: IA MD-45977) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA R-10277) |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2021-01-13 |