| NPI | 1710996392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD425969) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301087344) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2011-11-28 |