| NPI | 1629087341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 036018) |
| Additional Taxonomies | 207LC0200X Anesthesiology Critical Care Medicine (Licence: GA 036018) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: GA 036018) | |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2013-05-15 |