| NPI | 1760539597 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 4301405347) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301405347) |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |