| NPI | 1417338203 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO DR.0074571) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL 35397) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL 35397) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2025-04-16 |