| NPI | 1609076066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NH 19737) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NV 12354) |
| 207L00000X Anesthesiology (Licence: CA A91765) | |
| Enumeration Date | 2007-07-23 |
| Last Update Date | 2022-08-11 |