| NPI | 1073716726 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D74525) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD d74525) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME110051) | |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2021-06-10 |