| NPI | 1003922931 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX D8318) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX G8318) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX G8318) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2019-08-20 |