| NPI | 1205826377 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD D0073072) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MD D73072) |
| Enumeration Date | 2005-10-28 |
| Last Update Date | 2024-05-21 |