| NPI | 1225324791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SD 12138) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 6652) |
| 207Q00000X Family Medicine (Licence: KS 7731) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2016019592) | |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2020-10-01 |