| NPI | 1164487526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: NC 37897) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: NC 37897) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2016-12-07 |