| NPI | 1821059676 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD061084L) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 17085) | 
| Enumeration Date | 2006-03-31 | 
| Last Update Date | 2024-06-18 |