| NPI | 1972588226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD068727L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D57996) |
| 207L00000X Anesthesiology (Licence: VA 0101049996) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2025-01-16 |