| NPI | 1457335523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 39495) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 39495-020) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 39495) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2022-06-29 |