| NPI | 1972594570 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 71225) |
| Additional Taxonomies | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: MA 71225) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MA 71225) | |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2019-09-30 |