| NPI | 1992138366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 77206) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: GA 77206) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2024-06-05 |