| NPI | 1568882934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: IA MD-45171) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: IA MD-45171) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2024-01-11 |