| NPI | 1265888994 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD473427) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 279660) |
| Enumeration Date | 2016-05-12 |
| Last Update Date | 2021-03-23 |