| NPI | 1669906186 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD474956) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA FV0642391) |
| Enumeration Date | 2017-04-12 |
| Last Update Date | 2025-01-30 |