| NPI | 1760643472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD457219) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2012-02188) |
| 207L00000X Anesthesiology (Licence: VA 0101246832) | |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2016-09-14 |