| NPI | 1932106176 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME 121448) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PR 5608) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2014-09-05 |