| NPI | 1619313475 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 71477-20) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: ME MD29439) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 71477-20) | |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2025-11-25 |