| NPI | 1679598544 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 58022) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD041502E) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-02-14 |