| NPI | 1992997514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NC 2011-00453) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0116019803) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 2011-00453) | |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2014-10-29 |