| NPI | 1487891255 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD440826) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 60251679) |
| Enumeration Date | 2009-01-14 |
| Last Update Date | 2022-07-08 |