| NPI | 1023168739 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: FL ME38962) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: FL ME38962) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2011-02-03 |