| NPI | 1417996364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MO 2005030691) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2005030691) |
| 207L00000X Anesthesiology (Licence: MO 2005030691) | |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2022-06-23 |