| NPI | 1336180314 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CT 033132) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CT 033132) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2010-07-09 |