| NPI | 1376509935 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD428758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 229650) |
| Enumeration Date | 2006-04-24 |
| Last Update Date | 2017-04-06 |