| NPI | 1447561857 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 345041)  | 
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO FW2014023581)  | 
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2014023581)  | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX Q3305)  | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 345041)  | |
| Enumeration Date | 2010-06-30 | 
| Last Update Date | 2025-04-21 |