| NPI | 1750671400 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 076420) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 262007) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2021-02-15 |