| NPI | 1801909726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD035287E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME112848) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2021-02-25 |