| NPI | 1972585313 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME139050) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A80592) |
| 207L00000X Anesthesiology (Licence: FL ME139050) | |
| 208D00000X General Practice (Licence: HI 12671) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2024-03-25 |