| NPI | 1508813445 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD441213) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 19090) |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-07-24 |