| NPI | 1790756617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: HI MD-9085) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 9767) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 9767) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2023-09-06 |