| NPI | 1790796233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD429974) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 12812) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 12812) | |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2022-09-12 |