| NPI | 1427001502 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME68749) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME68749) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-01-03 |