| NPI | 1366457236 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WA MD60323495) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: UT 5566449-1205) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WA MD60323495) | |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2014-10-20 |