| NPI | 1215227160 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN MD50135) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD474025) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2021-09-22 |