| NPI | 1548427966 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101016081) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101016081) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2025-04-10 |