| NPI | 1083703789 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD047473L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME 013690) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-24 |