| NPI | 1649455775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MA 250849) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MD P21922) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 250849) | |
| Enumeration Date | 2008-01-08 |
| Last Update Date | 2024-07-23 |