| NPI | 1922394477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD455254) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT199192) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2015-09-01 |