| NPI | 1437539723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME145552) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.41249) |
| 207L00000X Anesthesiology (Licence: PA MT208191) | |
| 207L00000X Anesthesiology (Licence: TX S2592) | |
| Enumeration Date | 2015-06-02 |
| Last Update Date | 2026-07-28 |