| NPI | 1629068093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD060043L) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA MD060043L) |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2014-02-18 |