| NPI | 1669904959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301507484) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301507484) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL 149677) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MI 4301507484) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: MI 4301507484) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301507487) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4301507484) | |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-01-26 |