| NPI | 1861054181 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AR E17096) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology Pain Medicine (Licence: AR E-17096) |
| Enumeration Date | 2019-07-08 |
| Last Update Date | 2024-09-12 |