| NPI | 1720049950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MI 5101013847) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL OS12525) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101013847) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2024-01-26 |