| NPI | 1689930927 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 007301) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 007301) |
| 207R00000X Internal Medicine (Licence: MI 5101019864) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 007301) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2025-04-18 |