| NPI | 1043275449 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MD D0050726) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0050726) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2012-04-05 |