| NPI | 1235239187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD420919) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: ME 8081) |
| 207Q00000X Family Medicine (Licence: ME 8081) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2013-08-20 |