| NPI | 1770587115 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NM MD2016-0037) |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NM MD2016-0037) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2022-07-21 |