| NPI | 1316200165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD478568) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 28047) |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2022-07-20 |