| NPI | 1720127913 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 42621) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 42621) |
| 207L00000X Anesthesiology (Licence: KY 42621) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01072411A) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2022-06-09 |