| NPI | 1225325582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA C171725) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 284086) |
| 207R00000X Internal Medicine (Licence: PA MT199409) | |
| Enumeration Date | 2011-07-06 |
| Last Update Date | 2021-12-09 |