| NPI | 1447287636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: OR MD19519) |
| Additional Taxonomies | 207LP2900X Anesthesiology Pain Medicine (Licence: OR MD19519) |
| 207L00000X Anesthesiology (Licence: OR MD19519) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-01-27 |