| NPI | 1417343559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MS 33695) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO DR.0064172) |
| Enumeration Date | 2015-04-15 |
| Last Update Date | 2024-10-10 |