| NPI | 1871504902 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME106558) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 105147) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 105147) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2012-08-08 |