| NPI | 1174151740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101027263) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 5101027263) |
| 207P00000X Emergency Medicine (Licence: MI 5101027263) | |
| Enumeration Date | 2020-03-30 |
| Last Update Date | 2024-10-04 |