| NPI | 1356464523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MS 19781) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: AL 25576) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MS 19781) | |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AL 25576) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2021-04-27 |