| NPI | 1851683999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME MD20069) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT195305) |
| 207L00000X Anesthesiology (Licence: SC MMD87298) | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2024-01-19 |