| NPI | 1174919690 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA OS021171) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS021171) |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2021-05-25 |