| NPI | 1194774117 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MI 5101008294) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MI 5101008294) |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 5101008294) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: MI 5101008294) | |
| 207L00000X Anesthesiology (Licence: MI 5101008294) | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2024-01-26 |