| NPI | 1467422667 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MN 39860) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 50730) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MN 39860) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 50730) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME80188) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2020-08-04 |