| NPI | 1881897932 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LA0401X Anesthesiology, Addiction Medicine (Licence: ID M-10047) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: ID M-10047) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2025-06-16 |