| NPI | 1407822067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: FL OS14239) |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 038152) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: GA 038152) | |
| Enumeration Date | 2006-02-24 |
| Last Update Date | 2018-05-22 |