| NPI | 1871554881 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME50386) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 28013) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 28013) | |
| 207L00000X Anesthesiology (Licence: MA 225216) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2023-11-13 |