| NPI | 1700818804 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 41050) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 41050) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: TN MD4150) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2022-01-26 |