| NPI | 1255317210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 80948) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 80948) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2024-04-23 |