| NPI | 1295120764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 86438) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CO DR.0064353) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CO DR.0064353) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2023-05-26 |