| NPI | 1407822091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 41395) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2013-00553) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 41395) | |
| 207L00000X Anesthesiology (Licence: FL ME0087738) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2023-09-25 |