| NPI | 1164925038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A146468) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: CA A146468) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A146468) | |
| Enumeration Date | 2018-03-16 |
| Last Update Date | 2025-01-26 |