| NPI | 1396955795 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MD D80521) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: MD D80521) |
| 208000000X Pediatrics (Licence: MD D80521) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2024-12-13 |