| NPI | 1417119009 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 33157) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 258192) |
| 207L00000X Anesthesiology (Licence: PA MD449206) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2024-07-08 |