| NPI | 1699971465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA MD206599) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: LA MD206599) |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2024-07-10 |