| NPI | 1801115076 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 261214) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 003538-1) |
| 207L00000X Anesthesiology (Licence: PA MT189107) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2023-12-07 |