| NPI | 1598290868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME154608) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME154608) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2023-10-23 |