| NPI | 1528383965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: TX T3554) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 48237) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 48237) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 48237) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 48237) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2023-08-15 |