| NPI | 1679675060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 13042) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 13042) |
| 207LA0401X Anesthesiology, Addiction Medicine (Licence: NV 13042) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: NV 13042) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 13042) | |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2023-12-15 |