| NPI | 1801042890 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MS 22113) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MS 22113) |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2013-04-23 |