| NPI | 1669423505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD454920) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA G51834) |
| 207L00000X Anesthesiology (Licence: ME 018240) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2022-12-07 |