| NPI | 1902900582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: GA 035332) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: GA 035332) |
| 207L00000X Anesthesiology (Licence: GA 035332) | |
| Enumeration Date | 2006-09-12 |
| Last Update Date | 2024-10-02 |