| NPI | 1558355776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD420566) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101255144) |
| 207L00000X Anesthesiology (Licence: PA BH8311653) | |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2022-08-02 |