| NPI | 1528015088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 040733) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: RI MD14204) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: CT 040733) | |
| Enumeration Date | 2006-05-30 |
| Last Update Date | 2022-02-23 |