| NPI | 1699208918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MS 29895) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 29895) |
| 207LP2900X Anesthesiology Pain Medicine (Licence: MS 29895) | |
| Enumeration Date | 2017-04-04 |
| Last Update Date | 2022-04-26 |