| NPI | 1811044621 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 44260) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: TN MD44260) |
| 207L00000X Anesthesiology (Licence: TN MD44260) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2025-12-02 |