| NPI | 1043494883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NY 264669) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT190078) |
| 2083C0008X Preventive Medicine Clinical Informatics (Licence: NY 264669) | |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2021-04-12 |