| NPI | 1790078848 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 16996) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 16996) |
| 208600000X Surgery (Licence: PA MT199661) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 16996) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2022-07-21 |