| NPI | 1164501920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD459318) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G8370) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2019-10-28 |