| NPI | 1912950023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME86864) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME86864) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2021-03-17 |