| NPI | 1609856723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD025443E) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD025443E) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD025443E) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: DE C10008831) | |
| 207L00000X Anesthesiology (Licence: PA MD025443E) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: DE C10008831) | |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2021-01-12 |