| NPI | 1508839689 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 01042223A) | 
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01042223A) | 
| Enumeration Date | 2006-02-09 | 
| Last Update Date | 2025-09-11 |