| 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 Specialist (Licence: NY 264669)  | |
| Enumeration Date | 2007-12-27 | 
| Last Update Date | 2021-04-12 |