| NPI | 1013302181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CO CDR.0004748) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S4299) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX S4299) | |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2025-03-04 |