| NPI | 1225322803 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA OP60725018) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WA OP60725018) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AK 101145) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA OP60725018) | |
| Enumeration Date | 2011-06-01 |
| Last Update Date | 2020-09-12 |