| NPI | 1457321648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 64716) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 14017R) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2022-01-26 |