| NPI | 1033178785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME63976) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 38953) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2018-09-22 |