| NPI | 1457451734 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 40978) | 
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 40978) | 
| Enumeration Date | 2006-09-25 | 
| Last Update Date | 2013-06-10 |