| NPI | 1699749606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME143629) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME143629) |
| 207L00000X Anesthesiology (Licence: MN 47900) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2023-03-24 |