| NPI | 1376684936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD472910) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0109542042) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101247931) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2024-09-11 |