| NPI | 1881153724 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD H0100665) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MD H0100665) |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2024-06-28 |