| NPI | 1346261385 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MD D0069389) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: IA 36089) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2011-01-24 |