| NPI | 1629338348 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME137410) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.41538) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2023-11-30 |