| NPI | 1720171143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 29038) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 29037) |
| 207L00000X Anesthesiology (Licence: AZ 29038) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2023-03-07 |