| NPI | 1487035408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4301512541) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301512541) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-09-04 |