| NPI | 1366737421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: NV 16513) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 16513) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 16513) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A136824) | |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2024-04-18 |