| NPI | 1871580167 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: PA MD458699) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME61360) |
| 207L00000X Anesthesiology (Licence: AZ 17490) | |
| 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME61360) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME61360) | |
| Enumeration Date | 2005-10-01 |
| Last Update Date | 2016-10-10 |