| NPI | 1346270063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 37050) |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine (Licence: AZ 37050) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 37050) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2019-09-05 |