| NPI | 1740243609 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA C152074) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA C152074) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 34920) | |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2024-03-14 |