| NPI | 1447788047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL MD.42654) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 42654) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: LA 340536) | |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2025-04-24 |