| NPI | 1508839689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01042223A) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: IN 01042223A) |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2007-07-08 |