| NPI | 1548403447 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2016012612) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2016012612) |
| Enumeration Date | 2009-04-08 |
| Last Update Date | 2018-03-17 |