| NPI | 1063583268 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 41100) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01062749A) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 41100) | |
| Enumeration Date | 2006-11-11 |
| Last Update Date | 2022-06-09 |