| NPI | 1942613989 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: FL ME138495) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME138495) |
| Enumeration Date | 2014-06-07 |
| Last Update Date | 2023-08-15 |