| NPI | 1497748008 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: DC MD042715) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD046604L) |
| 207L00000X Anesthesiology (Licence: MD D0039769) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD046604L) | |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2022-01-14 |