| NPI | 1750649703 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME135070) |
| Additional Taxonomies | 208VP0000X (Licence: FL ME135070) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME135070) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2025-03-23 |