| NPI | 1699936914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: SC 35457) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 35457) |
| Enumeration Date | 2008-06-19 |
| Last Update Date | 2019-09-19 |