| NPI | 1487628442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 34825) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 34825) |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-02-24 |