| NPI | 1568456077 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: FL ME85199) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL md85199) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: FL me85199) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL md85199) | |
| 207L00000X Anesthesiology (Licence: FL ME85199) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2024-10-24 |