| NPI | 1316989023 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: TX J7566) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX J7566) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2017-10-26 |