| NPI | 1225041718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: AL 20137) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 49088) |
| 207LP2900X Anesthesiology, Pain Medicine (Licence: AL 20137) | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2011-03-02 |