| NPI | 1598176810 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD464872) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT206516) |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2021-06-16 |