| NPI | 1164417648 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD029698E) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: PA MD029698E) |
| 208VP0000X (Licence: PA MD029698E) | |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2011-10-17 |