| NPI | 1356545081 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 40432) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 201200567) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 40432) | |
| 207L00000X Anesthesiology (Licence: NC 201200567) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2024-01-03 |