| NPI | 1821277443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 71294) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 243641) |
| 207L00000X Anesthesiology (Licence: PA MD459207) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD459207) | |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2016-10-17 |