| NPI | 1629082763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD437257) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD437257) |
| 207R00000X Internal Medicine (Licence: PA MD437257) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2022-10-12 |