| NPI | 1609163880 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 54063) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 23847) |
| Enumeration Date | 2011-07-07 |
| Last Update Date | 2023-03-15 |