| NPI | 1396272357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WA MD61448450) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: ID M-17197) |
| Enumeration Date | 2017-05-20 |
| Last Update Date | 2024-03-05 |