| NPI | 1689616005 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD0222446) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA md0222446) |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA MD0222446) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD0222446) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2021-09-29 |