| NPI | 1962455204 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 25522) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 200746) |
| 207L00000X Anesthesiology (Licence: AL 25522) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2024-01-31 |