| NPI | 1174884662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 77552) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 29319) |
| Enumeration Date | 2012-05-31 |
| Last Update Date | 2022-08-19 |