| NPI | 1962666701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO DR.0052675) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AZ MD.00065030) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2025-05-05 |