| NPI | 1609914662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AZ 42847) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 42847) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ 42847) | |
| 207L00000X Anesthesiology (Licence: AZ 42847) | |
| Enumeration Date | 2007-02-02 |
| Last Update Date | 2023-07-31 |