| NPI | 1619911591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 057571) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD424709) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2024-03-04 |