| NPI | 1326241563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 64985) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 64985) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: GA 64985) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2013-05-14 |