| NPI | 1578850756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 58632) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AR E-9046) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: AZ 58632) | |
| 207L00000X Anesthesiology (Licence: MI 4301099459) | |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2024-05-14 |