| NPI | 1679576813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: SC 19839) |
| Additional Taxonomies | 174400000X Specialist (Licence: SC 19839) |
| 207L00000X Anesthesiology (Licence: SC 19839) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: SC 19839) | |
| 246ZG1000X Specialist/Technologist, Other, Geneticist, Medical (PhD) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2022-11-18 |