| NPI | 1972602043 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD045904L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD045904L) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2024-09-17 |