| NPI | 1407475247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CT 80666) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1018593) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 1018593) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 80666) | |
| Enumeration Date | 2020-04-12 |
| Last Update Date | 2025-07-06 |