| NPI | 1164402392 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 28699) |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: TN 28699) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TN 28699) | |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2023-11-17 |