| NPI | 1881631661 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD478203) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25MA09871000) |
| 207L00000X Anesthesiology (Licence: NY 202707-1) | |
| Enumeration Date | 2006-06-01 |
| Last Update Date | 2024-05-23 |