| NPI | 1346238136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CO 33258) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WY 7058A) |
| 207L00000X Anesthesiology (Licence: CO 33258) | |
| Enumeration Date | 2005-10-06 |
| Last Update Date | 2016-10-06 |