| NPI | 1073074597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME168493) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 31819) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2024-05-22 |