| NPI | 1316382583 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 49551) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ R73764) |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2019-12-31 |