| NPI | 1144221151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: LA 014664) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: LA 014664) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 014664) | |
| 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: LA 014664) | |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2014-02-26 |