| NPI | 1588849020 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 66370) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 002760) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX P7913) | |
| Enumeration Date | 2008-01-03 |
| Last Update Date | 2021-09-08 |