| NPI | 1306209267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD479907) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME143774) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD479907) | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2023-03-01 |