| NPI | 1033327309 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: DE C1-001253) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD435427) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD435427) | |
| 208VP0000X (Licence: DE C1-0012532) | |
| 208VP0000X (Licence: PA MD435427) | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2023-05-04 |