| NPI | 1598703852 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 25243) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: MS 25243) |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: FL Me72004) | |
| Enumeration Date | 2006-06-02 |
| Last Update Date | 2023-10-24 |