| NPI | 1134337397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME164008) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OH 35123158) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301087850) | |
| 207L00000X Anesthesiology (Licence: MI 4301087850) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2024-05-16 |