| NPI | 1881809747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA OS014319) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OT010768) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS014319) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2017-01-03 |