| NPI | 1477554897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD472951) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0048287) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2023-11-06 |