| NPI | 1992908503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: PA MD042726L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME58589) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: PA MD042726L) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD042726L) | |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: PA MD042726L) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: PA MD042726L) | |
| 208D00000X General Practice (Licence: PA MD042726L) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD042726L) | |
| Enumeration Date | 2007-06-09 |
| Last Update Date | 2020-06-23 |