| NPI | 1164770400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 270771) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: RI MD15822) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 270771) | |
| Enumeration Date | 2012-08-16 |
| Last Update Date | 2024-11-12 |