| NPI | 1184832362 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 4301085721) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MI 4301085721) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: MI 4301085721) | |
| Enumeration Date | 2007-05-19 |
| Last Update Date | 2022-08-16 |