| NPI | 1598051278 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A123278) |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A123278) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA 123278) | |
| Enumeration Date | 2011-06-22 |
| Last Update Date | 2026-04-14 |