| NPI | 1407156953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 762671) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 58.003847) |
| 207L00000X Anesthesiology (Licence: SC 37600) | |
| 207L00000X Anesthesiology (Licence: GA 72671) | |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2022-08-19 |