| NPI | 1598963787 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MT191531) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-6815) |
| Enumeration Date | 2007-07-10 |
| Last Update Date | 2021-01-10 |