| NPI | 1659337459 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 5695) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NV 5695) |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2022-07-21 |