| NPI | 1962433417 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NV 8342) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: AZ 32323) |
| 261QP3300X Clinic/Center, Pain (Licence: NV 8342) | |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 32323) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2008-03-07 |