| NPI | 1598862682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME34699) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME34699) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2009-12-15 |