| NPI | 1831233071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME106013) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 227668) |
| Enumeration Date | 2007-02-19 |
| Last Update Date | 2021-03-31 |