| NPI | 1720375793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: PA MD440039) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NY 261989) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2013-08-06 |