| NPI | 1609281138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX T1219) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TX T1219) |
| Enumeration Date | 2014-06-23 |
| Last Update Date | 2022-12-06 |