| NPI | 1821090028 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD-053076-L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD-053076-L) |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2023-06-01 |