| NPI | 1265094312 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 73787) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 73787) |
| Enumeration Date | 2019-06-28 |
| Last Update Date | 2025-03-04 |