| NPI | 1972595874 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IN O200621A) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: VA 0102201558) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: PA 05010776L) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 045817) | |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2021-09-29 |