| NPI | 1104815422 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD019897E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD019897E) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2013-08-01 |