| NPI | 1306894795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD430917) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WV 13325) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2021-10-04 |