| NPI | 1780997312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD452964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C1-0011181) |
| 208600000X Surgery (Licence: PA MT196756) | |
| Enumeration Date | 2010-07-25 |
| Last Update Date | 2024-01-25 |