| NPI | 1043228364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 023101) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 023101) |
| 207L00000X Anesthesiology (Licence: GA 023101) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2011-09-28 |