| NPI | 1861755852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD457474) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD457474) |
| 207L00000X Anesthesiology (Licence: MA 293047) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 293047) | |
| Enumeration Date | 2012-06-24 |
| Last Update Date | 2022-08-11 |