| NPI | 1295129401 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 27777) |
| Additional Taxonomies | 208D00000X General Practice (Licence: FL ME135881) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME135881) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME135881) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 296341) | |
| 207L00000X Anesthesiology (Licence: NY 296341) | |
| 207L00000X Anesthesiology (Licence: FL ME135881) | |
| 207L00000X Anesthesiology (Licence: MS 27777) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: MS 27777) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: NY 296341) | |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2021-07-19 |