| NPI | 1477609899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME168754) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 35835) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL ME168754) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: AZ 35835) | |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2024-06-06 |