| NPI | 1306999289 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD434136) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD434136) |
| 207R00000X Internal Medicine (Licence: PA MD434136) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2024-04-26 |