| NPI | 1194229641 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.46510) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME167977) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2025-12-04 |