| NPI | 1427076595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: MS 11988) |
| Additional Taxonomies | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: AL 15545) |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2019-02-20 |