| NPI | 1285912790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: KY 49384) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY TP099) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2024-04-03 |