| NPI | 1588096804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME151296) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NJ 25ma09338300) |
| 207L00000X Anesthesiology (Licence: ID M-12516) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: ID m-12516) | |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2025-02-28 |