| NPI | 1932456381 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD477435) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 309192) |
| Enumeration Date | 2012-08-03 |
| Last Update Date | 2022-09-15 |