| NPI | 1023227576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 85478) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME136132) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME136132) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2022-01-03 |