| NPI | 1881900256 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101262965) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD448697) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2018-03-17 |