| NPI | 1700080520 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101242315) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101242315) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0101242315) | |
| 207L00000X Anesthesiology (Licence: MD D69687) | |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2023-11-27 |