| NPI | 1366496457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME138842) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 29897) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2019-03-20 |