| NPI | 1306887179 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 82167) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME82167) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2013-07-17 |