| NPI | 1336193077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD430007) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 184157) |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2009-11-02 |