| NPI | 1013169549 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 206570) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: LA MD.206570) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 206570) | |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2023-06-19 |