| NPI | 1992740617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 104825) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD064716L) |
| 207L00000X Anesthesiology (Licence: PA md-064716L) | |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2025-08-04 |