| NPI | 1235320151 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 059896) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 059896) |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 059896) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: GA 059896) | |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2016-12-12 |