| NPI | 1679797369 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0075394) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0009637) |
| 207R00000X Internal Medicine (Licence: MD D75394) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: DE C1-0009637) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2025-07-07 |