| NPI | 1447592357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD463191) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301504256) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2021-07-23 |