| NPI | 1174186183 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2024-02147) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101271380) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101271380) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 93076) | |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2024-08-05 |