| NPI | 1295788529 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME134552) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 027911) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 27911) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2022-08-30 |