| NPI | 1821225640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA L-240223) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD444888) |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2022-02-04 |