| NPI | 1497041537 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PR 21797) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PR 21797) |
| 207L00000X Anesthesiology (Licence: FL ME136658) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2023-04-04 |