| NPI | 1093782377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 81999) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 042-0008480) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VT 042-0008480) | |
| Enumeration Date | 2006-03-04 |
| Last Update Date | 2015-08-06 |