| NPI | 1255395695 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: KS 0431141) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: KS 0431141) |
| Enumeration Date | 2006-04-13 |
| Last Update Date | 2016-03-25 |