| NPI | 1528100625 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: KY 44705) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: KY 44705) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2024-08-26 |