| NPI | 1376036137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS023005) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA OS023005) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: NJ 25MB11944300) | |
| Enumeration Date | 2018-06-07 |
| Last Update Date | 2024-02-20 |