| NPI | 1285856765 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MT186511) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 23570) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2009-07-21 |