| NPI | 1558771238 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME140144) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME140144) |
| 208600000X Surgery (Licence: MA 260520) | |
| 207L00000X Anesthesiology (Licence: FL ME140144) | |
| 207L00000X Anesthesiology (Licence: MA 1024959) | |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2025-09-23 |