| NPI | 1649403254 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD459401) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 212506) |
| 207LC0200X Anesthesiology Critical Care Medicine (Licence: NY 255125) | |
| Enumeration Date | 2009-08-30 |
| Last Update Date | 2021-10-16 |