| NPI | 1932693090 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD477155) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: PA MD477155) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: PA MD477155) | |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2023-09-29 |