| NPI | 1932194701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: PA MD060379L) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD060379L) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: DE C1-0006593) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: DE C1-0006593) | |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2023-04-19 |