| NPI | 1114274057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NV DO2196) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: NV 56552) |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2020-11-23 |