| NPI | 1528054947 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 68268-21) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 222707) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV DO1620) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 222707) | |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2018-03-17 |