| NPI | 1144304346 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX J0170) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX J0170) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX J0170) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2021-06-03 |