| NPI | 1548267222 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 35253) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 35253) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2020-10-29 |