| NPI | 1437569779 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0086636) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0086636) |
| 207R00000X Internal Medicine (Licence: PA MT206248) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2020-11-02 |