| NPI | 1356370282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX J0908) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J0908) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2025-06-04 |