| NPI | 1316921778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 30685-20) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: WI 30685-020) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 30685-020) | |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2024-08-01 |