| NPI | 1568670214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 69400) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD439966) |
| 207L00000X Anesthesiology (Licence: GA 069400) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2022-12-30 |