| NPI | 1598730848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 67964) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 042002) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 67964) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2025-08-11 |