| NPI | 1760479430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME75237) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL ME75237) |
| Enumeration Date | 2005-09-28 |
| Last Update Date | 2023-02-27 |