| NPI | 1629225032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: HI MD17795) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: NY 264765) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2020-02-08 |