| NPI | 1831133420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME142336) |
| Additional Taxonomies | 207LH0002X Anesthesiology, Hospice and Palliative Medicine (Licence: FL ME142336) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2020-11-03 |