| NPI | 1558394437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 25487) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 25487) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: NC 25487) | |
| 208D00000X General Practice (Licence: NC 25487) | |
| 208VP0000X (Licence: NC 25487) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2018-07-11 |