| NPI | 1477518207 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101232575) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101232575) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2021-07-27 |