| NPI | 1992123590 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: FL ME139916) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AL MD.36864) |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2019-05-14 |