| NPI | 1083776215 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD436578) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT186664) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD436578) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD436578) | |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2020-01-30 |