| NPI | 1134530926 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME139293) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: AL MD38074) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME139293) | |
| 207LP2900X Anesthesiology Pain Medicine (Licence: GA 085105) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME139293) | |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2024-08-15 |