| NPI | 1437123775 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 34623) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MN 46136) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2020-09-01 |