| NPI | 1356501779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME126127) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME126127) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME126127) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2022-04-26 |