| NPI | 1154548071 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 58715) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 000322) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 058715) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME97782) | |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2025-08-08 |