| NPI | 1245254168 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301062475) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MI 4301062475) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2007-07-08 |