| NPI | 1538117015 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 053050) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 053050) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 053050) | |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2014-12-02 |