| NPI | 1720280266 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: PA LT000632) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA LT000632) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA LT000632) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-07-08 |