| NPI | 1376618470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME0069243) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL me0069243) |
| 2086S0129X Surgery, Vascular Surgery (Licence: FL ME69243) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2017-04-04 |