| NPI | 1760482111 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 10744) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: AL 10744) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL 10744) | |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2023-12-10 |