| NPI | 1699771840 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0034758) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD-044927-E) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2025-02-11 |