| NPI | 1154307635 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 4992) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 4992) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 46286) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 4992) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 4992) | |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2020-11-23 |