| NPI | 1073141362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS22508) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS22508) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS22508) | |
| Enumeration Date | 2020-03-31 |
| Last Update Date | 2026-08-20 |