| NPI | 1326185869 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301081418) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301081418) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D64305) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4301081418) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301081418) | |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2019-05-29 |