| 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) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301088007) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL me121992) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2024-03-27 |