| NPI | 1811983620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME74829) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME74829) |
| Enumeration Date | 2005-09-27 |
| Last Update Date | 2008-02-29 |