| NPI | 1548490709 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 2012-00520) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 201200520) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NC 201200520) | |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2024-07-10 |