| NPI | 1982633889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: ID M-13074) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: TX L1250) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX L1250) | |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2024-09-10 |