| NPI | 1811153604 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 45755) |
| Additional Taxonomies | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: AZ 45755) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 45755) | |
| 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: AZ 45755) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 45755) | |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2022-09-02 |