| NPI | 1306820113 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 200100039) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 200100039) |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2024-05-17 |