| NPI | 1548212137 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LA0401X Anesthesiology Addiction Medicine (Licence: TN 24297) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: TN MD0000024297) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2024-03-18 |