| NPI | 1376794842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WV 25058) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD439637) |
| 207L00000X Anesthesiology (Licence: WV 25058) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD439637) | |
| Enumeration Date | 2008-10-02 |
| Last Update Date | 2019-07-25 |