| NPI | 1336102441 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301117172) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD11449) |
| 207L00000X Anesthesiology (Licence: MA 219701) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: RI MD11449) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 219701) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2020-01-16 |