| NPI | 1225003353 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: NC 9601768) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 9601768) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2022-04-22 |