| NPI | 1962665513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA OS015724) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS015724) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2018-08-18 |