| NPI | 1275584104 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD072791L) |
| Additional Taxonomies | 207ZC0008X Pathology, Clinical Informatics Specialist (Licence: PA MD072791L) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD072791L) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2025-12-31 |