| NPI | 1609925429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 49505) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD439911) |
| Enumeration Date | 2007-01-10 |
| Last Update Date | 2015-08-26 |