| NPI | 1326073594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101232177) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101232177) |
| 207L00000X Anesthesiology (Licence: NC 200300178) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2008-03-20 |