| NPI | 1063653582 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A181380) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A181380) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2024-05-16 |