| NPI | 1154385557 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: IA MD-32573) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: IA 32573) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2022-10-26 |