| NPI | 1194715938 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NM MD2004-0201) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 2004-0201) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NM 2004-0201) | |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2022-04-14 |