| NPI | 1659561330 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD432564) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD432564) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MT185312) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2025-03-31 |