| NPI | 1154421915 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 23320) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 23320) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 057825) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2021-02-15 |