| NPI | 1417167784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS10812) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 5101015925) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2022-01-28 |