| NPI | 1063949758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD478087) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT213225) |
| 207L00000X Anesthesiology (Licence: CA A171810) | |
| Enumeration Date | 2017-05-12 |
| Last Update Date | 2022-12-29 |