| NPI | 1205827904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: ID M8793) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ID M8793) |
| Enumeration Date | 2005-11-02 |
| Last Update Date | 2024-01-18 |