| NPI | 1326497629 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD473373) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: PA MT210453) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD473373) | |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2023-10-19 |