| NPI | 1588633655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NM 98-188) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NM 98-188) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2019-11-19 |