| NPI | 1144780685 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: ME DO3809) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS023223) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS023223) | |
| Enumeration Date | 2019-03-21 |
| Last Update Date | 2024-05-31 |