| NPI | 1619322492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX S7040) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX S7040) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2023-06-12 |