| NPI | 1336285790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 303289) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: MD T1725) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 291417) | |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2023-06-29 |