| NPI | 1891716122 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD431970) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA MD00046490) |
| 207L00000X Anesthesiology (Licence: PA 431970) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2022-05-19 |