| NPI | 1821522152 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NJ 25MB11398700) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS022687) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: DE C2-0024049) | |
| Enumeration Date | 2017-04-13 |
| Last Update Date | 2024-02-02 |