| NPI | 1609066349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD474210) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD28434) |
| 207L00000X Anesthesiology (Licence: VA 0101236938) | |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2024-07-30 |