| NPI | 1174811194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0079999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT194531) |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2021-06-14 |