| NPI | 1457395832 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA MD.025590) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA 025990) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2025-04-08 |