| NPI | 1548640204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD470769) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT209016) |
| Enumeration Date | 2015-06-08 |
| Last Update Date | 2020-06-24 |