| NPI | 1447698469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 58110) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2015-01028) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME135395) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: ND 16772) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2020-08-05 |