| NPI | 1922412444 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD467167) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 275017) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2019-09-09 |