| NPI | 1023177664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MA 279391) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 27939) |
| 207L00000X Anesthesiology (Licence: IN 01077041A) | |
| 207L00000X Anesthesiology (Licence: NY 235329) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IN 01077041A) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2019-09-12 |