| NPI | 1801008891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: VA 0101246251) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: VA 0101246251) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: VA 0101246251) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2024-07-02 |