| NPI | 1518086560 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 5101016093) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS10746) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-03-22 |