| NPI | 1902830839 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME93136) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME 93136) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME 93136) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME93136) | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2014-03-14 |