| NPI | 1639143829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AR E2108) |
| Additional Taxonomies | 174400000X Specialist (Licence: PA MD058177L) |
| 207L00000X Anesthesiology (Licence: AR E2108) | |
| 207L00000X Anesthesiology (Licence: MN 65023) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX T2195) | |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2025-11-25 |