| NPI | 1255657557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TN 52762) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD450891) |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2022-03-22 |