| NPI | 1427541051 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: UT 5907189-1204) |
| Additional Taxonomies | 207LA0401X Anesthesiology, Addiction Medicine (Licence: KS 94-09463) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2023-11-13 |