| NPI | 1720080914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD033313E) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD-033313-E) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2023-05-30 |