| NPI | 1699789156 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME 97818) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OR MD212145) |
| 208600000X Surgery (Licence: NY 239844) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME97818) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2024-05-21 |