| NPI | 1881983500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME129132) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 125.060561) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: FL ME129132) | |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2020-09-08 |