| NPI | 1598904500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: GA 64371) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 64371) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN MD0000045009) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 64371) | |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2016-11-01 |