| NPI | 1699954172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: AR E-6777) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AR E-6777) |
| 207L00000X Anesthesiology (Licence: AR E-6777) | |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2021-08-20 |