| NPI | 1740287564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME93636) |
| Additional Taxonomies | 208VP0000X (Licence: FL ME93636) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2025-02-18 |