| NPI | 1952396236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TN 0000019104) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TN 19104) |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2024-03-08 |