| NPI | 1164456240 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 05BDLQK) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 059148) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 0000026586) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2022-07-22 |