| NPI | 1902193402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD449561) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME114349) |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2013-08-19 |