| NPI | 1821484031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: TX S4779) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX S4779) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2022-08-14 |