| NPI | 1174586267 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101016685) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 5101016685) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 5101016685) | |
| 207L00000X Anesthesiology (Licence: MI 5101016685) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2024-01-26 |