| NPI | 1790737716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME41447) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME0041447) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2012-07-11 |