| NPI | 1043225840 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN 01044269A) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KY 44875) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 44875) | |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2018-06-13 |