| NPI | 1417697079 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD489231) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA LT000908) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-06-10 |