| NPI | 1225558448 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NE 33707) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NE 33707) |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2025-06-06 |