| NPI | 1942665138 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OR MD218019) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA 184920) |
| 207L00000X Anesthesiology (Licence: CA 184920) | |
| Enumeration Date | 2015-12-15 |
| Last Update Date | 2024-07-04 |