| NPI | 1992238414 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AZ 008885) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: AZ 008885) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-06-03 |