| NPI | 1487094074 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 68012) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 68012) |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2021-11-19 |