| NPI | 1972589315 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: PA MD028703E) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD028703E) |
| Enumeration Date | 2005-12-19 |
| Last Update Date | 2007-10-31 |