| NPI | 1699062364 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X (Licence: TN 52491) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 52491) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TN MD0000052491) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 52491) | |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2022-09-23 |