| NPI | 1184923468 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 65890) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 65890-20) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 65890-20) | |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2021-11-23 |