| NPI | 1255342937 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: PA MD042667L) |
| Additional Taxonomies | 207T00000X Neurological Surgery (Licence: PA MD042667L) |
| Enumeration Date | 2006-08-10 |
| Last Update Date | 2008-03-26 |