| NPI | 1568427979 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101233975) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101233975) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0057001) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D0057001) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-11-21 |