| NPI | 1558351692 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD458018) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME 96402) |
| 207L00000X Anesthesiology (Licence: FL me96042) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2023-11-03 |