| NPI | 1912971482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD062916L) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD062916L) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-10-19 |