| NPI | 1922397660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 65914) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 65914-20) |
| Enumeration Date | 2011-04-04 |
| Last Update Date | 2021-11-29 |