| NPI | 1700876844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 155502) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MA 155502) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 155502) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2020-11-23 |