| NPI | 1285602748 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: WI 34795) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: WI 34795) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2022-02-23 |