| NPI | 1477537660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 83519) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: SC 82138) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME128542) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2023-03-15 |