| NPI | 1962404731 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD049863L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD049863L) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2024-01-31 |