| NPI | 1801816228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX G5795) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G5795) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX G5795) | |
| 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TX G5795) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TX G5795) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2022-08-25 |