| NPI | 1245322197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: FL ME19455) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME19455) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2015-08-25 |