| NPI | 1912070764 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IA DO-05077) |
| Additional Taxonomies | 208VP0000X (Licence: ND 24847) |
| 207L00000X Anesthesiology (Licence: WI 49712) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IA DO-05077) | |
| 207L00000X Anesthesiology (Licence: IA DO-05077) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2026-08-20 |