NPI | 1487176665 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301506756) |
Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301506756) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301506756) | |
Enumeration Date | 2017-07-10 |
Last Update Date | 2025-09-24 |