| NPI | 1114916608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL me0063186) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME0063186) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2023-07-31 |