| NPI | 1992870380 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME 95069) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: FL ME 95069) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: SC 15078) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 15078) | |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2013-09-19 |