| NPI | 1750323846 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: VA 0101057593) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: VA 0101057593) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: VA 0101057593) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2017-01-18 |