| NPI | 1164464194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 052109) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 052109) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 052109) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2018-07-05 |