| NPI | 1700115888 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD043926L) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD043926L) |
| Enumeration Date | 2009-12-18 |
| Last Update Date | 2009-12-18 |