| NPI | 1477514479 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX g8270) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX G8270) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX G8270) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-07-21 |