| NPI | 1760472708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD.14728) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL 00014728) |
| Enumeration Date | 2005-10-21 |
| Last Update Date | 2018-04-10 |