| NPI | 1386713600 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101243251) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 204370) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2021-12-06 |