| NPI | 1598734873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101271261) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD00043158) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA MD00043158) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2023-08-25 |