| NPI | 1598935900 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 5322) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 5322) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 5322) | |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2009-07-06 |