| NPI | 1629097571 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA OS006962E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA OS006962E) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA OS-006962E) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-02-05 |