| NPI | 1700829017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD040073E) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: PA MD040073E) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2015-09-03 |