| NPI | 1558347534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 83665) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD061797L) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2024-05-13 |