| NPI | 1184010597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 19872) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME133682) |
| 207R00000X Internal Medicine (Licence: FL TRN21142) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME133682) | |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2022-01-03 |