| NPI | 1073660841 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME131621) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 84102) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2019-11-22 |