| NPI | 1972760437 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: PA MD445564) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: PA MD445564) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: MD D76301) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA D76301) | |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2021-06-09 |