| NPI | 1538321187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD443056) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT190104) |
| 207L00000X Anesthesiology (Licence: NJ 25MA11393400) | |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2022-06-21 |