| NPI | 1699268870 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD478587) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT215705) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2022-08-03 |