| NPI | 1942274105 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 34609) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 34609) |
| 207L00000X Anesthesiology (Licence: MN 48111) | |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2022-01-21 |