| NPI | 1831313378 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A91492) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: CA A91492) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA A91492) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2014-10-07 |