| NPI | 1992266217 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD481667)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT221691)  | 
| Enumeration Date | 2019-03-28 | 
| Last Update Date | 2023-08-14 |