| NPI | 1073535506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M6181) |
| Additional Taxonomies | 170100000X Medical Genetics, Ph.D. Medical Genetics (Licence: ID M6181) |
| 208VP0000X Pain Medicine Pain Medicine (Licence: ID M6181) | |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2024-02-05 |