| NPI | 1801916754 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D73326) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D73326) |
| 207L00000X Anesthesiology (Licence: PA MD436054) | |
| 207L00000X Anesthesiology (Licence: PA MT188496) | |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2019-08-05 |