| NPI | 1992090138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME126263) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IL 125059899) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 49164) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2023-10-13 |