| NPI | 1003875212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OK 3116) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OK 3116) |
| 207Q00000X Family Medicine (Licence: OK 3116) | |
| Enumeration Date | 2006-03-17 |
| Last Update Date | 2021-07-06 |