| NPI | 1003234949 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101268241) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD463857) |
| 207L00000X Anesthesiology (Licence: PA MD463857) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2025-04-27 |