| NPI | 1700017936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OR MD213627) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MT188008) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MT188008) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60212422) | |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2023-01-11 |