| NPI | 1508277302 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD468894) |
| Additional Taxonomies | 208600000X Surgery (Licence: PA MT206864) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2023-02-17 |