| NPI | 1083661805 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301083310) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A92369) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301083310) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-03-12 |