| NPI | 1285085449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME144675) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125.068834) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2021-11-11 |