| NPI | 1770531337 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME171960) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 17681) |
| 207L00000X Anesthesiology (Licence: MS 17681) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2026-01-13 |