| NPI | 1285084376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 21162) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R76096) |
| 207P00000X Emergency Medicine (Licence: PA MT211140) | |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2021-07-29 |