| NPI | 1538206644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 41788) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A95611) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 41788) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-12-08 |