| NPI | 1689695421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD043257L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME153604) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME153604) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-07-13 |