| NPI | 1386839041 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: ND 12189) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: ND 12189) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2012-09-07 |