| NPI | 1821303413 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101271084) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD451943) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2020-12-09 |