| NPI | 1154367894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME62204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD456715) |
| Enumeration Date | 2006-06-21 |
| Last Update Date | 2019-05-31 |