| NPI | 1285615260 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX J5738) | 
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J5738) | 
| 207L00000X Anesthesiology (Licence: TX J5738) | |
| 174400000X Specialist (Licence: TX J5738) | |
| Enumeration Date | 2005-11-08 | 
| Last Update Date | 2025-09-15 |