| NPI | 1578609699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101243576) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD473956) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2022-08-03 |