| NPI | 1265450456 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301042284) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301042284) |
| 207L00000X Anesthesiology (Licence: IA MD-50984) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2023-07-02 |