| NPI | 1366494700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: SC 23773) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: SC 23773) |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2017-02-20 |