| NPI | 1790862977 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS011916) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NJ 25MB07771400) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: PA OS011916) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: CA 20A8689) | |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2024-01-02 |