| NPI | 1447413190 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2012-01181) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 51911) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 2012-01181) | |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2023-04-06 |