| NPI | 1154324234 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NJ MB068037) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: NY 214784-1) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MI 5101018041) | |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2021-07-13 |