| NPI | 1932321346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 12078813-1205) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD153282) |
| 207L00000X Anesthesiology (Licence: PA MT188120) | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2023-09-19 |