| NPI | 1790907103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NY 287055) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT188909) |
| 207L00000X Anesthesiology (Licence: PA MD439415) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2023-07-19 |