| NPI | 1629395454 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MS 25293) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 25293) |
| Enumeration Date | 2010-05-04 |
| Last Update Date | 2018-09-14 |