| NPI | 1326005703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IA 25065) |
| Additional Taxonomies | 174400000X Specialist (Licence: IA 25065) |
| 207L00000X Anesthesiology (Licence: IA 25065) | |
| 173000000X Legal Medicine (Licence: IA 25065) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2021-06-28 |