| NPI | 1093134983 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NM MD2019-0261) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NM MD2019-0261) |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2020-02-17 |