| NPI | 1609862085 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: OH 35120667) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD047314L) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD047314L) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2022-07-21 |