| NPI | 1629022371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD417486) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD417486) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD417486) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2019-10-25 |