| NPI | 1548536469 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 54364) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A141107) |
| Enumeration Date | 2012-03-25 |
| Last Update Date | 2024-03-21 |