| 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 | 2024-02-05 |