| NPI | 1598069858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2015-00661) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT198516) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2021-04-07 |