| NPI | 1215048020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 200001460) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 200001460) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 200001460) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2014-10-27 |