| NPI | 1508834706 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME83445) |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME83445) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2022-10-06 |