| NPI | 1831184969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WV 19498) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: WV 19498) |
| 207L00000X Anesthesiology (Licence: NC 2017-00040) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2024-09-18 |