| NPI | 1184666521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KY 23356) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: KY 23356) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: KY 23356) | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2014-08-12 |