| NPI | 1013363506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA C210022) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35.142493) |
| 207L00000X Anesthesiology (Licence: CA C210022) | |
| 207L00000X Anesthesiology (Licence: FL ME150783) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35.142493) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME150783) | |
| Enumeration Date | 2016-05-13 |
| Last Update Date | 2026-07-21 |