| NPI | 1992939490 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: MS 23747) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD.205224) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME137791) | |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2019-03-25 |