| NPI | 1104133370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 261880) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 245114) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 245114) | |
| 207R00000X Internal Medicine (Licence: MA 245114) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MA 261880) | |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2023-12-15 |