| NPI | 1407050842 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 4805) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 93418) |
| 207L00000X Anesthesiology (Licence: MI 5101016644) | |
| 207L00000X Anesthesiology (Licence: GA 93418) | |
| 207L00000X Anesthesiology (Licence: TN 4805) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101016644) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2025-10-28 |