| NPI | 1952796799 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD471643) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 278305) |
| Enumeration Date | 2015-03-30 |
| Last Update Date | 2020-10-13 |