| NPI | 1821152802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD434184) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT184030) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2012-05-21 |