| NPI | 1750380614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD461996) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0063735) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2022-08-04 |