| NPI | 1225323785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 50572) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ D01889748) |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2019-10-14 |