| NPI | 1598801193 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 227852) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 62911) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0064332) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 62911) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME104842) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-07-21 |