| NPI | 1457372807 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101102628) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME169948) |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2025-03-25 |