| NPI | 1255355467 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine (Licence: CO 31118) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CO 31118) |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2013-08-29 |