| NPI | 1811288830 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD458934) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 295160) |
| Enumeration Date | 2011-04-25 |
| Last Update Date | 2020-08-31 |