| NPI | 1689642993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME87536) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IN 01078103A) |
| 207L00000X Anesthesiology (Licence: NY 227484-1) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME 87536) | |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2023-10-10 |