| NPI | 1457493611 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: FL ME105881) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL MD37392) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL me105881) | |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2023-11-30 |