| NPI | 1821088295 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD054657L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 102002) |
| 207L00000X Anesthesiology (Licence: FL ME157134) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2024-10-15 |