| NPI | 1831180983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 28685) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 28685) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2023-02-01 |