| NPI | 1619139268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD157078) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT192997) |
| Enumeration Date | 2008-06-25 |
| Last Update Date | 2012-06-01 |