| NPI | 1174636435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q6140) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 253466) |
| 207Q00000X Family Medicine (Licence: ME 018016) | |
| 208M00000X Hospitalist (Licence: ME 018016) | |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2018-03-17 |