| NPI | 1356669014 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME137285) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 274935) |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2022-08-23 |