| NPI | 1639608201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0091921) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT214011) |
| 207L00000X Anesthesiology (Licence: PA MT214011) | |
| Enumeration Date | 2017-06-07 |
| Last Update Date | 2021-10-19 |