| NPI | 1467482091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME55656) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL me 55656) |
| 207QA0505X Family Medicine, Adult Medicine (Licence: FL ME55656) | |
| 207R00000X Internal Medicine (Licence: FL ME55656) | |
| 208600000X Surgery (Licence: FL ME55656) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME55656) | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2024-10-17 |