| NPI | 1528056165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD041591E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD041591E) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2015-11-12 |