| NPI | 1457795247 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: OK 29872) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: OK 29872) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2023-06-20 |