| NPI | 1700029402 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 70849) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 70849) |
| 207LP3000X Anesthesiology, Pediatric Anesthesiology (Licence: GA 70849) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 70849) | |
| Enumeration Date | 2009-04-09 |
| Last Update Date | 2019-03-21 |