| NPI | 1396727756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 11534) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 11534) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 11534) | |
| 208VP0000X (Licence: NV 11534) | |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2026-02-03 |