| NPI | 1437689494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2022030141) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 9409314) |
| 207L00000X Anesthesiology (Licence: CA 20A18907) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-09-19 |