| NPI | 1992080618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A1496336) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: NY 274946) |
| 207L00000X Anesthesiology (Licence: IL 125059273) | |
| Enumeration Date | 2011-10-13 |
| Last Update Date | 2024-05-10 |