| NPI | 1558420893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS10480) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS10480) |
| 207L00000X Anesthesiology (Licence: FL uo-1422) | |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-07-26 |