| NPI | 1366433237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101277282) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME78094) |
| 207L00000X Anesthesiology (Licence: FL ME78094) | |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2026-06-15 |