| NPI | 1508934464 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MS 20298) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ME EC-05-091) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MS 20298) | |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-12-28 |