| NPI | 1538104161 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME 110154) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A83908) |
| 207L00000X Anesthesiology (Licence: FL ME110154) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2025-07-09 |