| NPI | 1457507055 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MS 21996) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS T2111) |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2021-08-18 |