| NPI | 1225097397 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 39925) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VT 03200052067) |
| 207L00000X Anesthesiology (Licence: WV 1438) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VT 03200052067) | |
| Enumeration Date | 2006-03-18 |
| Last Update Date | 2022-07-21 |