| NPI | 1417952722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 25777) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 25777) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: IN 01034477) | |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2025-04-18 |