| NPI | 1568881951 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 81358) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 081358) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2020-07-09 |