| NPI | 1922460070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: MA 1013043) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: NH 22525) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: NH 22525) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MA 1013043) | |
| Enumeration Date | 2016-03-27 |
| Last Update Date | 2026-03-31 |