| NPI | 1396232450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2022-01619) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 90529) |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2024-03-28 |