| NPI | 1619142882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD460204) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 245108) |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2022-08-19 |