| NPI | 1568849990 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 60636) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 60636) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2021-04-27 |