| NPI | 1134236763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101253335) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101253335) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2023-04-24 |