| NPI | 1215905054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: SC 158741) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: SC 15874) |
| Enumeration Date | 2006-03-09 |
| Last Update Date | 2016-10-21 |