| NPI | 1831533058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX R6182) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX R6182) |
| 207L00000X Anesthesiology (Licence: TX R6182) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: TX R6182) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2019-07-25 |