| NPI | 1023202280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: WI 81104) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME 120646) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME 120646) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME 120646) | |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2024-02-08 |