| NPI | 1730380478 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME-116391) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL TRN10915) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 245841) | |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2016-01-21 |