| NPI | 1538402334 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD476177) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD476177) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.131765) | |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2023-02-13 |