| NPI | 1932277563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 060024) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL TRN-7882) |
| 207L00000X Anesthesiology (Licence: FL ME 114487) | |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: GA 60024) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 60024) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2013-01-31 |