| NPI | 1093132912 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD472456) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA11008400) |
| 207L00000X Anesthesiology (Licence: VA 0101263555) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2021-08-17 |