| NPI | 1275573651 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CT 42555) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 42555) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 042555) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2017-07-19 |