| NPI | 1861784886 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD454587) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD454587) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NJ 25MA09934800) | |
| Enumeration Date | 2011-05-10 |
| Last Update Date | 2019-10-24 |