| NPI | 1932362944 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD447002) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD447002) |
| 207L00000X Anesthesiology (Licence: PA MT192591) | |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2022-07-21 |