| NPI | 1245294164 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D0037485) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD060826L) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0037485) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD060826L) | |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2013-02-06 |