| NPI | 1699911404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TX N7845) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX N7845) |
| 207L00000X Anesthesiology (Licence: TX N7845) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: TX N7845) | |
| Enumeration Date | 2008-12-29 |
| Last Update Date | 2021-06-14 |