| NPI | 1114994605 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: GA 043462) |
| Additional Taxonomies | 2085R0202X Radiology Diagnostic Radiology (Licence: IN 01055206A) |
| 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: IN 01055206A) | |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2018-07-20 |