| NPI | 1184676488 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: LA 008094) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: LA 008094) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2018-05-31 |