| NPI | 1790914273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD D0078033) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301092761) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: DE C1-0010385) | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2023-11-14 |