| NPI | 1033430640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 68489) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0055453) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO DR.0055453) | |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2021-12-21 |