| NPI | 1376566430 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO R9J90) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO R9J90) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MO R9J90) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2021-02-25 |