| NPI | 1649433111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 47840) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 14808) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 14808) | |
| 207L00000X Anesthesiology (Licence: AZ 47840) | |
| Enumeration Date | 2008-07-05 |
| Last Update Date | 2014-12-01 |