| NPI | 1093705998 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 22481) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD048421) |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2023-04-24 |