| NPI | 1114951282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: NH 10112) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: ME 013472) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MA 58840) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2008-09-15 |