| NPI | 1619286473 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD452089) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT197760) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2015-03-08 |