| NPI | 1417092073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX Q2426) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 50099) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 50099) | |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2022-12-27 |