| NPI | 1265964860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 70301) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: CT 70301) |
| Enumeration Date | 2017-04-02 |
| Last Update Date | 2022-05-10 |