| NPI | 1386604650 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 075048) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD H0059778) |
| Enumeration Date | 2006-03-23 |
| Last Update Date | 2018-07-02 |