NPI | 1528276771 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME121992) |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 96064) |
208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL me121992) | |
207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301088007) | |
Enumeration Date | 2007-05-20 |
Last Update Date | 2024-09-21 |