| NPI | 1285078832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME120992) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CO 60554) |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2022-10-07 |