| NPI | 1003022500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD428810) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA md422810) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: DE C1-0010968) | |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2023-04-21 |