| NPI | 1659634798 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A126641) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME143275) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 80330) | |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2023-07-11 |