| NPI | 1528068376 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: DC 31457) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME67116) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME67116) | |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2022-04-13 |