| NPI | 1376571489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2021-00457) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NY 166852) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2021-00457) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 166852) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2022-12-09 |