| NPI | 1457771073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MO 2021032687) |
| Additional Taxonomies | 207LC0200X Anesthesiology, Critical Care Medicine (Licence: MO 2021032687) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2021032687) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2022-07-05 |