| NPI | 1598025983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 2017-02041) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 51650) |
| 207L00000X Anesthesiology (Licence: NC 2017-02041) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2017-02041) | |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2023-02-05 |