| NPI | 1275951576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME152100) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 65547) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: WI 65547-20) | |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2022-03-24 |