| NPI | 1336671916 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101026675) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 5101026675) |
| Enumeration Date | 2017-04-01 |
| Last Update Date | 2023-05-09 |