| NPI | 1861443830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD031585E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 200600035) |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2023-03-07 |