| NPI | 1326115429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 13352) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 13352) |
| 208VP0000X (Licence: NV 13352) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 13352) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-07-28 |