| NPI | 1639195423 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD445968) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD445968) |
| 207L00000X Anesthesiology (Licence: PA MD445968) | |
| 207R00000X Internal Medicine (Licence: CT 040624) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-01-26 |