| NPI | 1659329811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 2005-01361) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NC 2005-01361) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2005-01361) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101238504) | |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2023-06-22 |