| NPI | 1124068762 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AR E-3580) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-3580) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2023-08-01 |