| NPI | 1699114025 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA OP61109043) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL DO.1957) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS15925) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2023-07-13 |