| NPI | 1649381146 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME97587) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME97587) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: NH 12671) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2024-08-15 |