| NPI | 1861620452 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD450759) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT195943) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2014-10-22 |