| NPI | 1720074230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS020103) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD H0062337) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2020-06-02 |