| NPI | 1356339840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME76691) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME76691) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2020-06-26 |