| NPI | 1275875932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD46119) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD223256) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2025-04-15 |