| NPI | 1619915972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D41289) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD460738) |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2017-06-01 |