| NPI | 1194819045 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 14282) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 14282) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2024-05-13 |