| NPI | 1295788412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME62685) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101248788) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2018-06-29 |