| NPI | 1912345950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0013096) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: DE C1-0013096) |
| 207L00000X Anesthesiology (Licence: NY 280002) | |
| 207R00000X Internal Medicine (Licence: PA MT-204127) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2021-11-27 |