| NPI | 1407964737 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: AZ 64010) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NM MD2022-1545) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2024-07-29 |