| NPI | 1730140542 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME161338) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OH 35078996) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME161338) | |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2024-04-19 |