| NPI | 1336250158 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 9800795) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 9800795) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 9800795) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2013-05-28 |