| NPI | 1699725382 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA DA020977A) |
| Additional Taxonomies | 122300000X Dentist (Licence: PA DA020977A) |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DS020977L) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: PA DA020977A) | |
| 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: PA DA020977A) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2023-11-17 |