| NPI | 1699726554 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 032179) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 032179) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 189623) | |
| Enumeration Date | 2006-05-15 |
| Last Update Date | 2022-10-19 |