| NPI | 1457653040 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: ME MD20571) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME MD20571) | 
| Enumeration Date | 2010-12-02 | 
| Last Update Date | 2020-11-11 |