| NPI | 1861755514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: DE C1-0012811) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D0083982) |
| 207R00000X Internal Medicine (Licence: MD P27690) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D0083982) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD460644) | |
| Enumeration Date | 2012-06-18 |
| Last Update Date | 2023-04-25 |