| NPI | 1487954723 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL ME117856) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 244805) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2022-03-03 |