| NPI | 1598147894 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME144662) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 274882) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2024-04-10 |