| NPI | 1265431035 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN 49170) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 49170) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 49170) | |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2022-07-21 |