| NPI | 1245203025 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 53974) | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 53974) | 
| 207L00000X Anesthesiology (Licence: IN 01055749A) | |
| Enumeration Date | 2006-02-10 | 
| Last Update Date | 2023-12-28 |