| NPI | 1447387543 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME109741) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101336723) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME109741) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2023-03-20 |