| NPI | 1548267131 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 32707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 32707) |
| Enumeration Date | 2005-06-28 |
| Last Update Date | 2022-04-04 |