| NPI | 1174664007 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD D0066706) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0066706) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: DC MD039935) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MD D0066706) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2017-11-27 |