| NPI | 1306157201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS12564) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: FL OS12564) |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2015-07-29 |