| NPI | 1447271366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: MO 2006019874) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MO 2006019874) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2016-02-08 |