| NPI | 1013985332 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME116737) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L3812) |
| 207L00000X Anesthesiology (Licence: LA 308260) | |
| 207L00000X Anesthesiology (Licence: OK 22889) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME116737) | |
| Enumeration Date | 2006-03-11 |
| Last Update Date | 2023-01-31 |