| NPI | 1518952555 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD038978E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D38813) |
| Enumeration Date | 2005-09-15 |
| Last Update Date | 2025-05-16 |