| NPI | 1043741705 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 28793) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX T6835) |
| 207L00000X Anesthesiology (Licence: MS 28793) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX T6835) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX T6835) | |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-04-17 |