| NPI | 1124075791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: OR md26192) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: OR MD26192) |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2012-09-18 |