| NPI | 1245271568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD045767L) |
| Additional Taxonomies | 208VP0000X (Licence: PA MD045797L) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2022-09-13 |